Vaginal Cancer

Treatment

The treatment options for vaginal cancer are:

• Topical therapy: Topical therapy involves topical formulations on the affected area. The therapy is used to manage vaginal intraepithelial neoplasia or vaginal pre-cancer. Topical therapy is not generally used for the treatment of invasive cancer. Some topical medications kill the pre-cancer cells (chemotherapy drugs), while others boost the immune system to act against the pre-cancer cells. Topical chemotherapy drugs may cause severe vulvar or vaginal irritation. The dosage regimen of most topical drugs for vaginal cancer is once a week.
• Laser surgery: The abnormal vaginal tissue is vaporized using the laser. The treatment is effective in vaginal intraepithelial neoplasia. It may also be used for large lesions but not for invasive cancer. The oncologists may repeat the laser surgery if required.
• Radiation therapy: Radiation therapy is most commonly used to treat vaginal cancer. The therapy is of two types, and vaginal cancer is generally treated through the combination of these two types of radiation therapies:
  External beam radiation therapy: The high-energy radiations are guided to the abnormal or cancerous cells from the machine located outside the body. This radiotherapy is used in combination with surgery to chemotherapy to shrink the size of the tumor.
• Brachytherapy: Brachytherapy for vaginal cancer involves placing the radioactive material inside the vagina or directly into the tumor. There are two types of brachytherapy:
  Intracavitary brachytherapy: The oncologists place the radioactive material in the vagina. Intracavitary brachytherapy may be low-dose rate (LDR) brachytherapy and high-dose-rate (HDR) brachytherapy. Radioactive material remains in the vagina for a long period in LDR brachytherapy compared to HDR brachytherapy. Brachytherapy is less likely to cause bowel and bladder side effects.
  Interstitial brachytherapy: The oncologists place the radioactive material directly into the tumor or the nearby tissues in interstitial brachytherapy.
• Surgery: The complexity of the surgery depends upon the stage of cancer.
  For cancer limited to the vaginal surface, the oncosurgeons remove the abnormal tissues along with some surrounding healthy tissues to make sure that all the abnormal cells are removed.
  Patients with advanced cancer may undergo vaginectomy. This procedure involves the removal of the partial or complete vagina. Vaginectomy may be accompanied by hysterectomy (removal of ovaries and uterus) or lymphadenectomy (removal of lymph nodes), depending upon the extent of the cancer spread.
  The oncosurgeons may perform pelvic exenteration in case vaginal cancer has spread to a maximum area of the pelvic region or if cancer has recurred. During the pelvic exenteration, the oncosurgeons remove several pelvic organs, such as the uterus, ovaries, vagina, rectum, bladder, and lower section of the colon.
• Chemotherapy: Chemotherapy is mainly used to manage vaginal cancer that has spread to other parts of the body. It is generally used in combination with radiation therapy for vaginal cancer. The oncosurgeons may also use chemotherapy before the surgery to shrink the tumor. Chemotherapy is delivered orally or through injection. The drug reaches the site of action through blood.